title: Clinical characteristics and direct medical cost of respiratory syncytial virus infection in children hospitalized in Suzhou, China.
abstract: BACKGROUND
  There have been few studies on children hospitalized with respiratory syncytial virus (RSV) published from mainland China. We performed a retrospective review of medical charts to describe the epidemiology, clinical features and direct medical cost of laboratory-proven RSV children hospitalized in Suzhou, China.
  
  
  METHODS
  Testing is routine for RSV for children admitted to the respiratory ward at Suzhou University Children's Hospital. We performed a retrospective study on children with documented RSV infection hospitalized at Suzhou University Children Hospital during 2005-2009 using a structured chart review instrument.
  
  
  RESULTS
  A total of 2721 hospitalized children (15.0% of those tested) were positive by immunofluorescent assay for RSV during 2005-2009, and 64.0% of them were male. Eighty-seven percentage of the RSV-infected children were 2 years old and younger, and 56.6% were ≤ 6 months of age. The median length of hospital stay was 8 days. Of the RSV-infected children, 92.5% developed pneumonia and 21.8% experienced wheezing. In total, 49 (5.1%) of RSV-positive children were transferred to the ICU. Children ≤ 6 months old and who had congenital heart disease had higher risk of severe RSV disease. The mean cost of each RSV-related hospitalization was US$571.8 (US$909.6 for children referred to ICU and US$565.4 for those cared for on the wards). Multivariable logistic regression showed that compared with the ≤ 6 months children, those aged >6 months old had higher hospitalization cost; children with respiratory distress or with chronic lung diseases tended to have higher hospitalization costs than others.
  
  
  CONCLUSIONS
  RSV infections and severe RSV diseases mostly occurred in early infancy. The direct medical cost was high relative to family income. Effective strategies of RSV immunization of young children in China may be beneficial in addressing this disease burden.
authors.affiliation: From the *Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai; †Suzhou University Affiliated Children's Hospital, Jiangsu Province, People's Republic of China; and ‡Center for Global Health, Cincinnati Children's Hospital, Cincinnati, OH.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Zhu
authors.forename: Xuelan
authors.initials: X
authors.lastname: Zhang
authors.forename: Yunfang
authors.initials: Y
authors.lastname: Ding
authors.forename: Mark
authors.initials: M
authors.lastname: Steinhoff
authors.forename: Steven
authors.initials: S
authors.lastname: Black
authors.forename: Genming
authors.initials: G
authors.lastname: Zhao
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors